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Saturday, May 28, 2011

There's currently a lot of hype surrounding circumcision and the transmission of HIV. The word on people's lips is that "circumcision reduces HIV transmission by 60%." The claim is based on the result of three major "studies" that were carried out in Africa, but there are a few confounding factors that bring the validity of these so-called "studies" into question. One of the greatest confounding factors in these studies is empirical evidence to the contrary; real world data from countries where circumcision is already a widespread practice and studies with contrary results.

Countries in Africa
Let's begin with countries in Africa, where these "studies" would be relevant. According to demographic health surveys performed in other countries in Africa, HIV transmission was prevalent in circumcised men in at least 6 different countries. I go one by one, analyzing some of the commentary in these surveys, some of which seems to be revealing of the researchers' bias.

Lesotho
In Lesotho, 23% of the men are circumcised, and the ratio circumcised men vs. intact men who contracted HIV was 22.8 vs 15.2.

"The relationship between male circumcision and HIV levels in Lesotho does not conform to the expected pattern of higher rates among uncircumcised men than circumcised men. The HIV rate is in fact substantially higher among circumcised men (23 percent) than among men who are not circumcised (15 percent). Moreover, the pattern of higher infection rates among circumcised men compared with uncircumcised men is virtually uniform across the various subgroups for which results are shown in thetable. This finding could be explained by the Lesotho custom to conduct male circumcision later in life, when the individuals have already been exposed to the risk of HIV infection. (Additional analysis is necessary to better understand the unexpected pattern in Table 12.9.)" (p. 13)

What is disturbing here is that it seems researchers grope for a reason to dismiss these results because they are not what they are looking for; a positive result for circumcision. The above is an interesting defense of male circumcision, given the fact that the latest "studies," if they can even be called that, observed HIV trasmission in men circumcised as adults. Then again, this demographic health survey was conducted in 2004, BEFORE the newer "studies" in 2006. None the less, the unproven assertion that "circumcision is only effective in reducing the risk of HIV when done in infancy" persists in some circles.http://www.measuredhs.com/pubs/pdf/FR171/12Chapter12.pdf

Malawi
In Malawi, 20% of the male population is circumcised. The ratio of circumcised vs. intact men who contracted HIV was 13.2 vs 9.5.

"The relationship between HIV prevalence and circumcision status is not in the expected direction. In Malawi, circumcised men have a slightly higher HIV infection rate than men who were not circumcised (13 percent compared with 10 percent). In Malawi, the majority of men are not circumcised (80 percent)(...where one would expect HIV to be the most rampant... note the "expected direction.") (p. 10)http://www.measuredhs.com/pubs/pdf/FR175/12Chapter12.pdf

Swaziland
In a recent demographic health survey (2006-2007), the ratio of circumcised vs. intact men who contracted HIV was found to be 22 vs. 20.

As Table 14.10 shows, the relationship between HIV prevalence and circumcision status is not in the expected direction. Circumcised men have a slightly higher HIV infection rate than men who are not circumcised (22 percent compared with 20 percent). (p. 256)http://www.measuredhs.com/pubs/pdf/FR202/FR202.pdf

Here is that "expected direction" again. The majority of Swazi men are uncircumcised, and one would especially expect to see HIV prevalence here. HIV transmission was more prevalent in the circumcised men here, yet our (the US) government has decided to spend millions on a campaign to circumcise 80% of the men in Swaziland.http://joseph4gi.blogspot.com/2011/05/soka-uncobe-our-us-tax-dollars-at-work.html

Other Countries Where HIV/Circumcision Rates Don't Correlate

Malaysia
According to Malaysian AIDS Council vice-president Datuk Zaman Khan, more than 70% of the 87,710 HIV/AIDS sufferers in the country are Muslims. In Malaysia, most, if not all Muslim men are circumcised, whereas circumcision is uncommon in the non-Muslim community. 60% of the Malaysian population is Muslim, which means that HIV is spreading in the community where most men are circumcised at an even faster rate, than in the community where most men are intact.http://www.thesundaily.my/node/142037

The Philippines
In the Philippines, the majority of the male population is circumcised, as it is seen as an important rite of passage. In the 2010 Global AIDS report released by UNAIDS in late November, the Philippines was one of seven nations in the world which reported over 25 percent in new HIV infections between 2001 and 2009, whereas other countries have either stabilized or shown significant declines in the rate of new infections. Among all countries in Asia, only the Philippines and Bangladesh are reporting increases in HIV cases, with others either stable or decreasing.http://newsinfo.inquirer.net/9299/philippines-not-making-progress-in-curbing-hiv-aids

In fact, AIDS rates in some US Cities rival hotspots in Africa. In some parts of the U.S., they're actually higher than those in sub-Saharan Africa. According to a 2010 study published in the New England Journal of Medicine, rates of HIV among adults in Washington, D.C. exceed 1 in 30; rates higher than those reported in Ethiopia, Nigeria or Rwanda.http://www.nejm.org/doi/full/10.1056/NEJMp1000069

The Washington D.C. district report on HIV and AIDS reported an increase of 22% from 2006 in 2009.

"[Washington D.C.'s] rates are higher than West Africa... they're on par with Uganda and some parts of Kenya."

One would expect for there to be a lower transmission rates in the United States, and for HIV to be rampant in Europe; HIV transmission rates are in fact higher in the United States, where most men are circumcised, than in various countries in Europe, where most men are intact. It is telling that the HIV epidemic struck in our country in the 1980s, 90% of the male population was already circumcised. Somehow, we're supposed to believe that what didn't worked in our own country, or anywhere else, is going to start working miracles in Africa.

Studies With Contrary Conclusions

According to USAID, "there appears no clear pattern of association between male circumcision and HIV prevalence—in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher."http://www.measuredhs.com/pubs/pdf/CR22/CR22.pdf

"Conclusions: We find a protective effect of circumcision in only one of the eight countries for which there are nationally-representative HIV seroprevalence data. The results are important in considering the development of circumcision-focused interventions within AIDS prevention programs."http://www.iasociety.org/Default.aspx?pageId=11&abstractId=2197431

One study which aimed at measuring male to female HIV transmission was ended early, because the results were not looking favorable. The Wawer study showed a 54% higher rate of male-to-female transmission in the group where the men had been circumcised. The figures were too small to show statistical significance, but there will be no larger scale study to find out if circumcising men increases the risk to women. Somehow that's considered unethical, yet it's considered ethical to promote male circumcision while not knowing if the risk to women is increased (by 54%?, 25%?, 80%? - who knows?)http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2809%2960998-3/fulltext

The latest study in Kenya finds no association between male circumcision and lowered HIV rates:'Using a population-based survey we examined the behaviors, beliefs, and HIV/HSV-2 serostatus of men and women in the traditionally non-circumcising community of Kisumu, Kenya prior to establishment of voluntary medical male circumcision services. A total of 749 men and 906 women participated. Circumcision status was not associated with HIV/HSV-2 infection nor increased high risk sexual behaviors. In males, preference for being or becoming circumcised was associated with inconsistent condom use and increased lifetime number of sexual partners. Preference for circumcision was increased with understanding that circumcised men are less likely to become infected with HIV.'http://www.plosone.org/article/info%3Adoi/10.1371/journal.pone.0015552?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+plosone/PLoSONE+%28PLoS+ONE+Alerts:+New+Articles%29

Conclusion
A few select studies show a prevalence of HIV transmission in uncircumcised men, but real world empirical data shows that circumcision hasn't stopped HIV in countries where there is already a prevalence of the practice of circumcision, nevermind the United States. Yet, for whatever reason, leaders at the WHO continue to endorse it as HIV prevention policy and millions are being spent on so-called "mass circumcision campaigns," even in countries where HIV transmission was shown to be prevalent among the circumcised.

Something must be done to alert our world leaders. Millions of precious funds are being used to promote a worthless surgical procedure that leaves men with permanently altered organs, and they are no better protected. The false security that the promotion of circumcision creates is actually helping to facilitate the spread of HIV. Funds are already scarce, and they could be better spent promoting cheaper, less invasive modes of prevention that have actually been proven to be conclusively effective, such as condoms and education. In light of the real-world evidence, promoting a worthless surgical procedure is an impertinent disservice in the fight against HIV/AIDS and governments need to be told to stop. Africans deserve better.

Related Post:

80% of American men were circumcised from birth. Yet, the United States has a higher prevalence rate than 53 countries where circumcision is rare or not practiced. The United States has more HIV than Mexico, its neighbor to the south. Read about this and more in the sequel post linked below.

Wednesday, May 25, 2011

In what I can only describe as an act of pure desparate idiocy, Diane Cole tries to launch a "rebuttal" to the proposed ban on male circumcision that will be on the San Francisco ballot this November, shooting her own self in the foot.

And then our very own HIV test results—his and hers—arrived. Peter was positive. I was negative. How had it happened that I never became HIV-positive myself?

It wasn't until recently that we knew: He was circumcised.

The claim is that circumcision is supposed to prevent HIV transmission in MEN, but this seems to escape her...

Poor circumcision advocates. So desperately they want to find some pseudo-scientific alibi for deliberate child abuse that they forget to switch their brains on.

Here's Cole's attempt to sound intelligent:

"...here is the reason I am alive today: In the same way that circumcision vastly diminishes the chance of infecting women with the human papillomavirus that causes cervical cancer, studies suggest that circumcision also helps guard against the transmission of the HIV virus. In both cases, cells on the inside of the male foreskin are implicated in spreading the virus. But if the foreskin is removed, a source of infection is also removed."

Actually, it has never been proven that circumcision reduces HPV, nor HIV for that matter. Few people know this, but the HIV "studies" are nothing but statistical analyses of data hand-picked by circumcision advocates that call themselves "scientists."

It's true. Ask a circumcision advocate to tell you how exactly circumcision prevents anything, and all they can do is point to three so-called "randomized controll trials" in Africa and give you that magical 60% figure we've all heard. But they can never, nor will they ever tell you with 100% certainty how exactly this happens. They cannot furnish a causal link, only ad-hoc/post-hoc explanations that they can't demonstrably prove. They may as well be trying to explain the existence of god.

Not even Cole could tell you. She mentions that cells inside the foreskin are implicated, but did she actually even bother to check which ones?

The cells she refers to are the Langerhans cells, and they were implicated in the spread of HIV, not HPV.

Actually, the Langerhans cells hypothesis was blown out of the water a long time ago.

Studies found that not only are Langerhans cells found all over the body and that their complete removal is virtually impossible, it was also found that Langerhans cells that are present in the foreskin produce Langerin, a substance that has been proven to kill the HIV virus on contact, acting as a natural barrier to HIV-1.http://www.circumcisionandhiv.com/files/de_Witte_2007.pdf

Americans have a cultural bias in favor of circumcision that will only allow them to see "studies" and "evidence" in favor of circumcision, and none that contradict it. The following information is found in many other of my posts regarding circumcision and the assertion that it prevents HIV:

Studies that found contradicting data:
According to USAID, "There appears no clear pattern of association between male circumcision and HIV prevalence—in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher."http://www.measuredhs.com/pubs/pdf/CR22/CR22.pdf

"Conclusions: We find a protective effect of circumcision in only one of the eight countries for which there are nationally-representative HIV seroprevalence data. The results are important in considering the development of circumcision-focused interventions within AIDS prevention programs."http://www.iasociety.org/Default.aspx?pageId=11&abstractId=2197431

Other countries where both HIV and circumcision are prevalent:
According to Malaysian AIDS Council vice-president Datuk Zaman Khan, more than 70% of the 87,710 HIV/AIDS sufferers in the country are Muslims. In Malaysia the majority of the males in the Muslim population are circumcised, whereas circumcision is uncommon in the non-Muslim community. This means that HIV is spreading in the community where most men are circumcised at an even faster rate, than in the community where most men are intact.http://www.mmail.com.my/content/39272-72-percent-aidshiv-sufferers-malaysia-are-muslims-says-council

In the 2010 Global AIDS report released by UNAIDS in late November, the Philippines was one of seven nations in the world which reported over 25 percent in new HIV infections between 2001 and 2009, whereas other countries have either stabilized or shown significant declines in the rate of new infections. Among all countries in Asia, only the Philippines and Bangladesh are reporting increases in HIV cases, with others either stable or decreasing.http://globalnation.inquirer.net/news/breakingnews/view/20110102-312124/Philippines-HIVAIDS-problem-worries-UN

"If the San Francisco initiative passes, and encourages other communities to do the same, who knows whose lives won't be saved."

The lives of circumcised men, that's for sure.

The "studies" that say circumcision might "reduce the risk of HIV" have serious flaws. They lack working hypotheses and their conclusions don't correlate with real world data.

But even assuming that they were 100% accurate, the reduction in HIV transmission would still only be 60% over a period of 1.5 years (the short duration of the studies), and only in female to male transmission. In light of the fact that condoms reduce the risk of HIV transmission, not to mention the transmission of other STDs, by over 90%, in BOTH partners, but most of all, in light of the fact that babies are at absolute zero risk for sexually transmitted HIV, or any other STDs for that matter, these "studies" would still be a moot point.

But we must ask ourselves, how much do we actually care about so-called "medical benefits?"

How interested would we be in the "potential medical benefits" for girls? Would we support further "research" into the matter? Would we allow the National Institutes of Health, Johns Hopkins etc., to fund "research" in Africa? Well what about countries where female circumcision isn't as "severe?"

But let's ask a different question, would we support "research" in finding alternative ways to provide the same "medical benefits" as male circumcision? If doctors came into your child's birthing room and said "We have great news! This new vaccine offers the same protections as circumcision and more! Now we don't have to circumcise your child anymore!" How would American parents react?

As always, the bottom line...
The foreskin is not a birth defect. Nor is it a congenital deformity or a genetic anomaly akin to a 6th finger or a cleft. The foreskin is normal, healthy tissue found in all males at birth.

Circumcision in healthy boys is the destruction of normal, healthy tissue. It permanently alters the appearance and mechanics of the penis, and it puts a child at risk of infection, disfigurment, complete ablation and even death.

Thanks to research and modern medicine, we now have better, more effective, less-invasive ways to prevent disease, so that circumcision is not needed anymore (actually, it was never needed).

Unless there is a medical or clinical indication, the circumcision of healthy, non-consenting individuals is by very definition infant genital mutilation. It is child abuse and a violation of basic human rights, and doctors have no business performing it in healthy, non-consenting individuals, much less giving his parents any kind of "choice."

Monday, May 23, 2011

We keep saying it, and we will continue to say it; nothing good can come of promoting circumcision over HIV. The promotion of circumcision is a disservice to the fight against HIV. It is already sending confusing messages and giving men a false sense of security. Promoting circumcision is going to HASTEN the spread of HIV, not reduce it.

The launch of safe male circumcision in Bushenyi District has been met with stiff resistance from church leaders, who say the practice is against morals.

Religious leaders said the way the medical people have packaged messages about male circumcision encourages people to go on sex rampage after the exercise.

The Rev. Can. Norbert Tibikoma, the Archdeacon for All Saints Church Greater Bushenyi, said the church will not compromise its morality.

"Telling people that circumcision will prevent them from the risk of HIV is very unfortunate. We have buried circumcised people who died of the disease. The way they are putting across their message of circumcision is like giving a licence to commit adultery.

It is like saying now you are free go and sin," he said during the launch of the exercise last week.He said the message from the church is that couples should remain faithful and those who are not yet married should abstain from premarital sex in order to avoid acquiring HIV.

The chaplain of Masheruka Girls SS, the Rev. Ananias Ntereyo, said the approach being used to promote male circumcision should be changed.

"Circumcision has been in existence for ages. Putting HIV/Aids at the fore will encourage people to have sex with multiple partners. We have seen those who are circumcised also getting the disease," he said.

May 04, 2011THE public has received the Male Circumcision campaign "Soka Uncobe" with mixed feelings as some people have come out to say the message was not clear.

A concern has been raised that the kombis which had been branded with the advertisements promoting the campaign display four women, which is said to be confusing as to whether once a person is circumcised they got more women. The logo itself, “Soka Uncobe” has raised a lot of questions as people wonder if by being circumcised it means one “has conquered” and would not get HIV and AIDS.

"If it had been the picture of a family including the wife supporting her man, who goes to circumcise then that would be better, but in this case you see four beautiful women and it says they are going to support you, it is really confusing. Are they now promoting multiple partners?" said one of the people who raised a concern. (HELLO???)

Solomon Mndzebele, who is a caregiver under Red Cross, made a personal plea to the ministry of health to remove the message from the kombis stating that it was making his work difficult.

"When you tell people about condoms they would just tell you that they would circumcise and by then they would have conquered HIV AIDS.

The Swazi Ministry of Health tries to explain away the blunder.

We could see it coming a million miles away. Most people with half a brain could predict that circumcision would become an alternative to condoms.

The "protection" circumcision provides is dubious at best. Real-world data shows us that circumcision is irrelevant in the fight against HIV/AIDS.

Contradicting Statistical Data

In the following African countries, HIV was found to be more prevalent among the circumcised:

According to USAID, "There appears no clear pattern of association between male circumcision and HIV prevalence—in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher."http://www.measuredhs.com/pubs/pdf/CR22/CR22.pdf

"Conclusions: We find a protective effect of circumcision in only one of the eight countries for which there are nationally-representative HIV seroprevalence data. The results are important in considering the development of circumcision-focused interventions within AIDS prevention programs."http://www.iasociety.org/Default.aspx?pageId=11&abstractId=2197431

According to Malaysian AIDS Council vice-president Datuk Zaman Khan, more than 70% of the 87,710 HIV/AIDS sufferers in the country are Muslims. In Malaysia the majority of the males in the Muslim population are circumcised, whereas circumcision is uncommon in the non-Muslim community. This means that HIV is spreading in the community where most men are circumcised at an even faster rate, than in the community where most men are intact.http://www.mmail.com.my/content/39272-72-percent-aidshiv-sufferers-malaysia-are-muslims-says-council

In the 2010 Global AIDS report released by UNAIDS in late November, the Philippines was one of seven nations in the world which reported over 25 percent in new HIV infections between 2001 and 2009, whereas other countries have either stabilized or shown significant declines in the rate of new infections. Among all countries in Asia, only the Philippines and Bangladesh are reporting increases in HIV cases, with others either stable or decreasing.http://globalnation.inquirer.net/news/breakingnews/view/20110102-312124/Philippines-HIVAIDS-problem-worries-UN

But even if the "studies" were 100% accurate, circumcision would still be a moot point.

Even if...

At best, circumcision would "reduce the risk of HIV by a 60%" (over 1.5 years), while a condom conclusively reduces the risk of HIV by over 90%. Circumcision would still fail. Circumcision fails, which is why even the very authors of the African "studies" themselves cannot stress the use of condoms enough. At best, circumcision would be like a permanent condom that broke 40% of the time. If "researchers" were promoting a condom that broke over 40% of the time, they'd be laughed out of the room!

Squaring circles...

Circumcision promoters actually think that they can make it work. They actually think that they can get African men to get circumcised AND wear a condom. Only in a perfect world...

A Deadly Shortcut

One must seriously wonder. What on earth are they smoking up at the WHO? Are American leaders on crack? How on EARTH does it make sense to promote a dubious alternative to the most effective method of HIV prevention known to us?

When "scientists" and "researchers" are more concerned with validating a historically controversial and ethically problematic surgical procedure, rather than finding and promoting less expensive, less invasive, more effective ways to reduce HIV transmission, we've got a serious problem.

"Botox is a key revenue driver for its maker Allergan Inc., based in Irvine, Calif. Sales grew 10.1 percent to $364.5 million during the first quarter. That total includes sales of Botox as a wrinkle treatment and other uses, including treatment for repeated migraine headaches and muscle spasms."

Hey! Did you know that circumcsion is a key revenue driver for certain medical professionals, and consumer product manufacturers?

1.3 million baby boys are circumcised a year in the United States alone. At a dollar per procedure, that is already $1,300,000 a year. The going rate for a circumcision procedure is approximately $300 American; multiplied by 1.3 million, that is approximately $390,000,000 a year that circumcision brings in based on the procedure alone.

Based in La Jolla, CA Advanced Tissue Sciences are the makers of Dermagraft-TC, which is an artifical skin created from harvested foreskins from infant circumcision.[1] They are also the makers of NouriCel, another product made from harvested foreskins,[2] and one of the main ingredients of SkinMedica's TNS Recovery Complex product.[3]

Dermagraft-TC is FDA approved,[4][5] and it sells for about $3,000 per square foot and one foreskin contains enough genetic material to grow 250,000 square feet of skin.[6]

Advanced Tissue Sciences has sold about $1 million worth of cultured dermis to Proctor & Gamble, Helene Curtis, and other such businesses for pre-market testing. Advanced Tissue Science's foreskin-derived merchandise held a $32 million stock offering in the beginning of 1992.[7]

In 1996 alone, Advanced Tissue Sciences could boast of a healthy $663.9 million market capitalization performance.[8]

So as you can see, there's more to circumcision that meets the eye. Scratch beneath the surface and you'll find an entire industry that solely depends on the continuance of the harvesting of foreskins from healthy, non-consenting individuals.

To close on the Botox bill:"Federal and state regulations already restrict the use of Botox on patients under 18. The new legislation would require doctors to document in a patient's chart the non-cosmetic medical reason for performing the procedure on a minor. Responsibility for adopting those regulations would be left to the state medical board and health commissioner.

The bill passed 10-1 in committee. There's no companion bill in the Senate."

In my opinion, it would be nice if male infant circumcision were regulated in exactly the same way. Unless it is medically necessary, restrict circmucision on patients under 18. Require doctors to document in a patient's chart the non-cosmetic medical reason for performing the procedure on minors. The state medical board and health commissioners should be responsible for adopting these regulations.

Thursday, May 19, 2011

So a recent news report from Richmond, VA finally highlights the fact that circumcisions can and do result in botches that have to be corrected later on.

The report sounds promising, giving the impression that doctors and parents are finally pondering the validity of putting children at risk for permanently mangled organs over an elective, medically unnecessary, cosmetic procedure.

Nope!

Basically, the conclusion is that staff needs to be better trained, and everyone completely ignores the best way to eliminate the possibility of a botched circumcision; leaving the poor child's genitals alone.

I've gone through and taken the report and inserted my own critique in parentheses. It's simply infuriating the way everyone pretends to be so utterly stupid and without a clue.

RICHMOND,VA (WTVR) - For some it's a cosmetic or health decision. For others, it's a religious covenant.

(And religion is relevant in medicine because???)

Regardless of the reason, a majority of baby boys born in the Greater Richmond Area today are being circumcised.

(Circumcision is SURGERY. It's CUTTING PART OF A CHILD'S PENIS OFF. The reason is DAMN WELL RELEVANT. But let's not dwell on it EVER.)

While circumcision is one of the most common procedures performed, a number of things can and do go wrong.

(Let's not talk about the fact that circumcision is elective, non-medical cosmetic surgery in a healthy, non-consenting newborn.)

Traci Stevens knew she didn't want her second baby to go through what her first son did. Stevens says, "My husband said over and over, 'Something's wrong.'"

(That first sentence is misleading. You think the woman grew a brain and decided her second son shouldn't be put through a needless risk. The plot thickens...)

Pediatric urologist Dr. Boyd Winslow confirmed what the Stevens feared, their first son's circumcision had been done wrong in the hospital and needed to be repeated. To spare their second born, Jonah, the same heartache, the Stevens took him directly to Dr. Winslow a month after he was born.

(WAIT, to "spare" their second born, they put him through the EXACT SAME RISKS??? Am I MISSING something here???)

Stevens says, "Jonah didn’t cry one bit when it was done, so I was very happy with that."

(Notice the wording; the child didn't cry. SHE was happy with that. I wonder how she would feel if she was the one undergoing the knife...)

(What, the bleeding and the crying? Or the fact that they're undergoing NEEDLESS SURGERY???)

Over the past three years, Winslow's practice has performed more than 1,600 repeat circumcisions. Some are minor fixes, others are major ones.

(Sounds like there's a market for repeat circumcision... It's not as "rare" as people would like to think...)

Dr. Winslow says, "The ones that have more serious problems can have so much skin removed that the penis becomes constrained and scarred or either bent and distorted."

(When was the "appropriate" amount of skin to be removed determined? What is there like a dotted line or something? FACT: The foreskin is normal, healthy tissue. The circumcised penis IS constrained, scared and distorted.)

So why is this happening?

(It should be obvious; children are being left with mangled penises ever a needless procedure. Do you really have to ask?)

"A lot of circumcisions are done on a newborn in a hurry," says Dr. Winslow.

(That's right, perhaps female circumcision wouldn't be so bad if the cutters weren't so hasty...)

Obstetricians have been doing circumcisions for years. One because they're experienced surgeons, and two, because they're in the hospitals with the new mothers.

(AKA, they get first dibs.)

Susan Lanni, The Medical Director for Labor and Delivery at VCU Medical Center says, "It’s really not our specialty, but by default it falls in our lap." She says with any medical procedure, there are complications, but says the majority of procedures are done correctly.

(Most medical procedures require a distinct medical REASON.)

Dr. Lanni goes on to say, "As a parent, I would want the person who has done the most procedures and felt the most comfortable with the procedure to be doing it and quite honestly nowadays, that’s the obstetrician."

(Shouldn't there be a MEDICAL REASON first? At its convention in Washington DC last week, the American College of Obstetricians and Gynecologists (ACOG) refused Intact America permission to place a stall among those offering medical products, etc, because circumcision is "beyond the scope of the practice of obstetrics and gynecology." How is it people can't lobby against them because it's outside their competence, and yet claim the right to do it? http://www.washingtonpost.com/rw/WashingtonPost/Content/Epaper/2011-05-02/Ax11.pdf)

Dr. Winslow doesn't dispute obstetricians should be the ones doing the circumcisions.

(Well he SHOULD. Obstetricians are specialists in women and childbirth. They have no particular competence at male genital surgery. Male infant circumcision is not even in their field of work.)

After all, there are roughly 4,500 baby boys born in Greater Richmond each year and statistics show 80-90% of them are circumcised, yet Winslow's Pediatric Urology practice is just one of two in town. He says, "We couldn't take on all those, we wouldn't dare offer that."

(Notice how encouraging parents and doctors to NOT be needlessly putting babies at risk by circumcising them isn't even talked about...)

But what Winslow is offering is his expertise. A year ago, he began doing presentations for local doctors to help them recognize problematic conditions and to perform the procedure as safely and painlessly as possible.

(Since they are not medically indicated, WHY PERFORM THEM AT ALL??? Is NOT circumcising part of Winslow's presentations? At 3:00 Dr Winslow shows a slide saying "Now the fun is over..." FUN? Does he know how close to the wind he is sailing, when there are are group of men who call themselves "circumsexuals" who take erotic pleasure from the idea of circumcising and being circumcised? They have websites and hold conventions. Better not to think about the fun they have at them.)

While the American Medical Association has set up guidelines for doctors to follow, the procedure is often left up to an individual physician’s discretion, and some don’t even use a local anesthetic.

(As if pain were even part of the issue...)

Dr. Winslow says there are ways doctors can improve the procedure and that has become his mission and says, "I've got my talk ready to give any place that wants to hear it."

(Shouldn't the first option, since it is not medically necessary, to try and convince doctors and parents NOT TO DO THIS AT ALL???)

Traci Stevens is thankful her little guy has a good start in life...

("Good start?" So baby boys are born defective straight out of the womb? The only two counties where the majority of baby boys are circumcised are Israel and the United States; even in Muslim countries it is mostly performed on older children. So children in the rest of the world are all off to "bad starts?" What self-serving, self-deluding, ad-hoc rubbish.)

...and Dr. Winslow says all babies deserve the same respect.

(The "respect" babies deserve is the right to their whole bodies.)

Dr. Winslow says, "Later on, little boys I can tell you, their penis becomes their best buddy and it means a lot to them."

(Yes. Have you ever wondered how they might feel about being circumcised? What if it meant a lot to them that some doctor never messed with their "best buddy" in the first place?

This statement is almost sick to think about. He can "tell us?" How can he "tell us" this? What does he CARE about a child's relationship to his penis, and why does he feel others are entitled to intervene?

Why can't we leave children's genitals alone???)

Some of the warning signs of a troubled circumcision include adhesions and scarring.

(Trouble that is needless and easily avoided by NOT circumcising...)

Doctor Winslow says the best time to circumcise a baby boy is in the first four weeks of life.

(The best time to circumcise a healthy, non-consenting individual is NEVER.)

However, if you're unsure whether circumcision is right for your child, consult your doctor first.

(The elephant in the room - not circumcising would eliminate any risk of a botch.)

And remember; these are the stats for just ONE CITY. How's the rest of America doing?

Bottom line, always the bottom line.
The foreskin is not a birth defect. Nor is it a congenital deformity or a genetic anomaly akin to a 6th finger or a cleft. The foreskin is normal, healthy tissue found in all males at birth.

Circumcision in healthy boys is the destruction of normal, healthy tissue. It permanently alters the appearance and mechanics of the penis, and it puts a child at risk of infection, disfigurment, complete ablation and even death.

Thanks to research and modern medicine, we now have better, more effective, less-invasive ways to prevent disease, so that circumcision is not needed anymore (actually, it was never needed).

Unless there is a medical or clinical indication, the circumcision of healthy, non-consenting individuals is by very definition infant genital mutilation. Doctors have no business performing it in healthy, non-consenting individuals, much less giving his parents any kind of "choice."

Doctors like Winslow are nothing less than charlatans justifying their trade.

"It's hard to get a man to understand something, when his livelihood depends on his not understanding."~Upton Sinclair

The citizens of this country can no longer ignore the elephant in the room. The apprehension this subject rouses in people is testament to what people really think of the matter. Some would like for it to be this "non-issue," but apprehension always, always betrays apathy.

The measure will never pass, but the good thing is that it is providing an opportunity for the citizens of this nation to educate themselves.

Wednesday, May 18, 2011

A ban on male infant circumcision is set to be put on the ballot for the November election in San Francisco, and those against it allege that the ban would infringe on "parental rights" and "religious freedom."

The state of Oregon has been the longtime home of the "Followers of Christ," an Oregon City-based, Christian sect whose members believe solely in prayer to treat sickness, in lieu of medicine. Optometry or dental care is sometimes exempt, but seeking medical help for one's self or one's sick children is prohibited. As a result, the church has a high child mortality rate, and a long history of children dying from treatable conditions.

Up until now, Oregon had maintained a two-track legal system that granted special legal privileges to parents with these religious beliefs. Using religion as a defense, it was possible for parents of said beliefs to let their children die of medical neglect, and they would automatically receive special treatment and lighter sentences by using religion as a defense.

For a time, many states granted immunity to parents who insisted on treating their sick children through prayer alone. However, many of them abandoned this approach, having realized that it was enabling child abuse in the name of the protection of "religious freedom."

Oregon has remained one of the few states to automatically shield faith-healing parents from prosecution for homicide or first-degree manslaughter. Said parents were also exempt from mandatory sentences under state Measure 11.

That is, until now.

After nearly 50 years of looking the other way, Oregon is finally changing its laws. As they stand, Oregon's current laws violate basic equal protection laws, requiring most parents in Oregon to meet the minimum standards of parenthood, while creating exemption for only a chosen few in the name of "religious freedom." The consequences of allowing this double-standard to continue has resulted in the deaths of many children.

Since 2009, several parents in the Followers of Christ church have been prosecuted or sanctioned for failing to provide their children with medical care. One child was a 15-month-old girl who died of untreated pneumonia and an infection. Another was a teenage boy who slowly died of an untreated urinary blockage. Another child suffered a massive untreated growth that disfigured her face and compromised her vision. It has taken these high-profile cases to finally force the Oregon Legislature to change.

Child advocate Rita Swan regretfully tells the story of her son who died in 1977, after she and her husband withheld necessary medical care, under the direction of their church. She explains why a single legal standard is not just a moral imperative for Oregon, but also a clearer guideline for people in religious sects.

"It would relieve parents of the moral tension of violating laws of the church," she says. "It would clarify what society expects of them."

The Oregon House has unanimously approved the faith-healing bill, and the Senate is expected to approve it this week (article published on May 15, 2011), after adding an "emergency clause" to speed its enactment. The sudden urgency, after so many years of deference and inaction, is a strange, bittersweet relief to some.

(I'd like to bet a dime to a dollar that the double-standard with male and female circumcision will persist though...)

So here you have a law that, for all intents and purposes, is going to infringe on the "religious freedoms" and "parental rights" of many.

Do objectors to the San Francisco Circumcision Ban voice their rage here?

Where do you draw the line?

How far should parents be allowed to go before we call child protective services on them?

When does an action cross the line from "religious freedom" and "parental rights" over to "child abuse?"

In treating male circumcision as a "religious freedom" and a "parental right," but banning any and every form of female genital cutting without religious exeption, aren't we maintaining a two-track legal system that grants special legal privileges to parents with a specific set of religious beliefs?

Why have we decided that only male circumcision should be defended in the name of "parental choice" and "religious freedom?"

It must be noted that circumcision can and often does result in complications, which include partial or full penile ablation (Google David Reimer for a famous case), infection, and yes, even death.

Yes, I'm sure that all surgeries have risks, but is putting a healthy, non-consenting child elective, cosmetic non-medical surgery justified?

The bottom line is always this: Unless there is a medical or clinical indication, can doctors even be performing surgeries in healthy, non-consenting individuals, much less be giving parents of said individuals any kind of "choice?" Is it even legal to be stoking a parents' sense of entitlement for a procedure that there isn't a medical indication for?

Sound familiar? Here are some of the highlights from the above article that I thought had shocking parallels with male infant circumcision:

"According to the mom, she injects the anti-wrinkle poison into her daughter's face to get rid of "wrinkles..."

Kerry (the mom) said that Britney (the daughter) wanted the Botox because of beauty pageant pressures. Kerry insists that Britney is the one who asked for the beauty treatment. Even so, why would the mom approve it much less inject it herself?

Kerry said, "We were getting into the pageants. I knew she was complaining about her face, having wrinkles, and things like that. When I brought it up to Britney she was all for it."

Some of the most common reasons for male infant circumcision are related to aesthetic preference. "It just looks better," say some parents and advocates of circumcision, "women prefer it this way, and I don't want my son to be made fun of in the locker room." Maybe this woman didn't want her daughter to be made fun of in the beauty pageant?

Here's another thing parents say; "my son says he's happy being circumcised." To confirm this they say, "I've asked him myself, and he thanks me every day." (Oh, does he now.)

I'm going to ask a similar, but familiar question; without medical or clinical indication, how is it doctors are performing circumcisions on healthy, non-consenting infants, much less stoking a parent's sense of entitlement?

Moving on:

"Normally children are only given Botox in cases of neuromuscular problems - not for the sake of beauty."

I must say.

Normally children are only given surgery where there is clinical or medical indication; not for the sake of aesthetic.

I will say that sometimes surgery IS performed for aesthetic reasons, such an when the child has a congenital deformity, birth defect, or genetic anomaly, such as a cleft, a 6th finger, or a disfiguring birthmark. But in these cases, there ARE genuine physical deformities that warrant surgical correction. The foreskin isn't an abnormality; it's normal, healthy tissue all boys are born with.

"These Botox injections are quite painful as you can see in the video below. Britney looks awful after the treatments with ice packs on her face. What kind of physical and psychological damage can these early beauty treatments cause to a young girl. Honestly, it is quite scary."

If injecting botox is "scary," I wonder what this author thinks of circumcising a child. Is anybody wondering about the physical and/or psychological damage that circumcising a young child can cause?

I encourage readers to watch a circumcision video. There are plenty on YouTube. Circumcision is also painful, as evidenced by the ear-splitting shrieks babies make when they're being circumcised.

"Babies can't remember being circumcised," some may say.

But of course, a baby wouldn't remember botox injections either.

This mother has lost her daughter's custody, and, in my opinion, rightfully so.

Now because of her actions, Kerry will have to own up to her poor decisions. CPS stated that there was no clear timetable about the custody issue. They also admitted that it could take some time before Britney can live with her mother. Officials are conducting a thorough investigation and are concerned about the child's psychological trauma about the situation.

Though it's heartbreaking to hear that a little girl is upset after being taken from her mother, a mother who elects to inject her 8-year-old with Botox is not a parent. She is making poor decisions for her child that could have severe long-term consequences. What was she thinking?

Kerry Campbell should look within herself before making such choices. It's despicable and though the ordeal is likely traumatic for Britney, it serves as a lesson for all the overbearing pageant moms out there.

Let kids be kids.

YES. Let kids be kids.

This is the whole message of the intactivist movement in a nutshell.

Notice the language in the above segment. It talks about decisions and choices that parents make. I've asked this in other posts, but is all that a parent decides to do with his/her children justified by mere virtue that one is a parent?

This mother chose to inject botox into her daughter. SHOULD she have had her daughter taken away from her? After all, it IS her daughter, and who is the state to come and tell her how to raise her children. This mother did what she thought was best. She wanted her daughter to "win" at the pageant. Was this mother really that bad of the parent?

"People have so many different opinions about Kerry losing her daughter, because she wasn't doing anything to harm her intentionally. Clearly the mother is obsessed with her daughter winning the pageant, but surely she can't be the first person to take things to another level, right?"

Right. ;-)

"A lot of people feel that Britney should not have been taken away from her mother, but disqualified from the beauty pageant instead. It's not like Britney was in danger or her mother was an unfit parent (to an extent)."

Really?

"It seems as though Kerry just let things get to her head. She injected Botox in to her daughter's face because she wanted her daughter to look flawless - and to win. While this isn't "okay" by any standards, is it something so terrible that she deserved to lose custody of her daughter?"

Is it?

If parents can pierce their daughter's ears, and circumcise their boys for aesthetic reasons, then it should only follow that parents should be allowed to inject botox into their daughters, right?

What wrong was it really, if this mother had the best intentions?

My mind's already made up; the road to hell is paved with good intent.

This is obviously another case of a pageant mother gone way out of hand.

Could it be parents insistent on having their sons circumcised are a different kind of "pageant parent" who don't want their child to "lose" in the lockerroom?

And could it be American medicine is capitalizing on this parental sense of entitlement?

A ban on infant circumcision has been proposed in San Francisco, and people are up in arms claiming that the ban would infringe on "religious freedoms," and, but of course, "parental rights."

I ask again; how far do we care about "parental rights" really? Just how far can a parent go with their children before we call it abuse and Child Protective Services has to step in?

You can circumcise your son to make him "look better" in the lockerroom, but you can't inject botox into your daughter so she can look good in the beauty pageant.

It seems the United States is funding the deliberate miseducation of African people.
Swaziland was one of many countries where HIV transmission was found to be more prevalent among CIRCUMCISED men.

"As Table 14.10 shows, the relationship between HIV prevalence and circumcision status is not in the expected direction. Circumcised men have a slightly higher HIV infection rate than men who are not circumcised (22 percent compared with 20 percent)". http://www.measuredhs.com/pubs/pdf/FR202/FR202.pdf

How in the world is it logical to promote a dubious "prevention method" that discourages the use of the most effective prevention method known to us?

I simply can't believe the level to which they're sinking. This campaign is not about HIV prevention, it's about coercing and berating men into getting a permanent surgical procedure with dubious "benefits" they may not need nor want. It's not about preventing more HIV cases, it's clearly about fulfilling a quota, at the expense of Swazi youth.

I feel sorry for those Swazi men and youth; it must be utterly humiliating to be approached to be asked about what are supposed to be your private parts, and to be made to feel like you're failing your country if you don't submit; like they actually care about your health and not about fulfilling a quota for your donors. What utter shame and disrespect for the men of Swaziland. What if you are married and faithful to your wife?

As I have shown in my last post on this subject, what we said would happen is already happening, and circumcision is proving to be a needless nuisance. Men are already using circumcision as an excuse to forgo condoms. When HIV workers try to talk to the men about condoms, the response is "It's OK doc, I'm circumcised, so I've already conquered HIV."

This project is going to fail. When it does, and the number of AIDS cases rises, will we be responsible? Or, like the Swaziland ministry of health, will we try to justify this horrendous mistake? Or will we continue to lie to the Swazi people and to pump millions into worthless genital mutilation to save face?

I am ashamed that this is what my tax dollars are being used for, the needless genital mutilation of African men and children.

Tuesday, May 10, 2011

It appears that after all, the Guinness Book of World Records will NOT be recognizing Marikina City's desparate attempt at recognition.

The City of Marikina held a "circumcision party" on May 7th in hopes of establishing a world record for people attending a "mass circumcision," but the city government hadn't checked with Guiness whether such a record could even be accepted.

On their website, Guiness has completely divorced itself of the event:

Statement from Guinness World Records

It has been bought to our attention that a circumcision event in the Philippines last Saturday has supposedly been approved by Guinness World Records.

Guinness World Records would like to clarify that it does not, under any circumstances, monitor, endorse or recognise this kind of 'record attempt'. The organisers of the event have no approval from Guinness World Records to use its trademarks in connection with this event and any claim to officially recognise this event will be rejected.

Like any other surgery, circumcision requires care and attention, rather than haste, as many things could go wrong. The child could have his penis partially or fully ablated, and there is risk for hemmorage and/or infection, not to mention there are ethical concerns in performing it on those too young to give informed consent. More than 1,000 boys were circumcised for the event, and at the end of it all, what did they get? No recognition, and mutilated organs for the rest of their lives. I have nothing but utter shame and disgust for the City of Marikina. An attempt at recognition at the expense of its youth.

According to vice mayor, Jose Fabian Cadiz, "We applied for the Guinness Book of World Records and we are recording everything so we can send all the data to them and hopefully it will be recognized."

In the Philippines circumcision is a rite of passage most males undergo as preteens, particularly during their school summer break from March to May. City officials took advantage of the season to throw a "circumcision party," as they had the local press sell the event.

They offered poor residents "free" circumcisions that would otherwise cost at least $40 in private hospitals. It sounds like a nice sentiment, since in rural areas, the surgery is sometimes performed by non-doctors using crude methods.

In Marikina, east of Manila, boys "receive" their "free" circumcisions.

Wherever I see this story, the comments all try to make light of the situation, with jokes and humor.

But let's stop for a minute.

What would be people's reactions if the gender of the subjects were female?

What if officials in some city in Malaysia or Indonesia were so starved for recognition they threw a "sunat" party and gave away free "sunat" for the girls there? You know, since girls are circumcised anyway, and they "might as well" be circumcised in a "clean environment?"

What if city officials planned to record this data and send it to the Guiness Book of World Records to see if they would get some sort of prize?

Girl receives "free" sunat, at a free circumcision event in Bandung, Indonesia, west of Java.

But it's not the same!

Before people start blubbering with their double-think, I'm going to attack some of the common myths that people spew to maintain the idea that "they're not the same" in their minds.

When female circumcision comes up, here are some of the common one-liners that people try to use to condemn female circumcision, but defend male circumcision.

"Female circumcision removes the clitoris, the labia, and the vulva is sewn up to leave only a small hole for urinating and menstruation; that's equivalent to castration in males."

Actually no, there are many kinds of female circumcision in the world, the WHO acknowledges this, and not every kind removes the clitoris.

The kind of female circumcision most people know, where all external genitalia is removed and the vaginal opening is stitched up, known as Pharaonic circumcision or infibulation, accounts for only 15% of cases globally.

In Indonesia, Malaysia and Singapore, the procedure ranges from rubbing turmeric on the genitals, to pricking the clitoris to draw a symbolic drop of blood. In other instances, the procedure is more invasive, involving what WHO classifies as “Type I” female genital mutilation, defined as excision of the clitoral hood, called the prepuce, with or without incision of the clitoris itself. The amount of flesh removed, if any, is described by circumcisers as being the size of a quarter-grain of rice, a guava seed, a bean, the tip of a leaf, the head of a needle. They use a small pair of sterilized scissors to cut a piece of the clitoral prepuce about the size of a nail clipping. In some areas, they do cut the clitoris itself.

In these countries, surveys show that over 95% of the female population undergoes some sort of "sunat" procedure, and the women seem to be doing fine.

In May, last year, the AAP tried to approve a "ritual nick" for girls. The procedure wouldn't remove anything, and the AAP admitted that it was much less severe than male circumcision. The logic behind this was that if they offered a "ritual nick" here in the States, then parents wouldn't take their daughters abroad to have more drastic procedures done. There was a world outcry, and the month of May did not end before the AAP was forced to retract their endorsement. The message was clear; under no circumstances were medical professionals to come near a girl's vulva with a knife, not even for a "ritual nick."http://www.time.com/time/health/article/0,8599,1988434,00.html

"Female circumcision is different from male circumcision, because it is meant to subjugate women and control their sexualities."

Actually, closer inspection reveals that this was precisely the reason it was done to boys.

"...with regard to circumcision, one of the reasons for it is... the wish to bring about a decrease in sexual intercourse and a weakening of the organ in question, so that this activity be diminished and the organ be in as quiet a state as possible...The bodily pain caused to that member is the real purpose of circumcision...
...violent concupiscence and lust that goes beyond what is needed are diminished. The fact that circumcision weakens the faculty of sexual excitement and sometimes perhaps diminishes the pleasure is indubitable. For if at birth this member has been made to bleed and has had its covering taken away from it, it must indubitably be weakened." ~Rabbi Moses Maimonides

"A remedy [for masturbation] which is almost always successful in small boys is circumcision...The operation should be performed by a surgeon without administering an anesthetic, as the brief pain attending the operation will have a salutary effect upon the mind... In females, the author has found the application of pure carbolic acid to the clitoris an excellent means of allaying the abnormal excitement." ~Dr. John Harvey Kellogg

But in the end, do the intentions really matter? What if doctors and parents seriously thought it made a woman's genitals cleaner and "more appealing" in their eyes? Just as many of us in America believe circumcision makes a boy "cleaner" and "more appealing?"

Let's change the intentions. For better for worse, mothers in these countries believe they are doing something good for their daughters. Does "sunnat" stop being abuse? Why this double-standard when it comes to male circumcision?

From the site:- The study found an overall satisfaction rate of 97.2% for women undergoing labiaplasty and clitoral hood reduction- An overall satisfaction rate of 83% in women having a vaginal tightening procedure (vaginoplasty/perineoplasty), and 91.2% for women combining both “outer” and “inner” work- Sexual satisfaction with 92.8% of women having both experienced improvement in their sexual satisfaction- The data also revealed that those women undergoing vaginal tightening (vaginoplasty) reported an estimated 82.2% overall improvement in their partner’s sexual satisfaction as well.

"Male circumcision is an imporant religious tradition in Judaism."

Surprise, surprise, according to the Indonesian Population Council study, many Indonesians view circumcision for boys and girls as a religious duty. But this isn't important, right?

"Studies show male circumcision could have health benefits. The same is not true for female circumcision."

And if they did?

Let's see how far people care about the "health benefits." What if there were "studies" that showed that female circumcision offered "potential medical benefits" for girls? Would we allow, request it for our daughters?

How interested would we be in the "potential medical benefits" for girls? Would we support further "research" into the matter? Would we allow the National Institutes of Health, Johns Hopkins etc., to fund "research" in Africa? Well what about these countries where female circumcision isn't as "severe?"

But let's ask a different question, would we support "research" in finding alternative ways to provide the same "medical benefits" as male circumcision? If doctors came into your child's birthing room and said "We have great news! This new vaccine offers the same protections as circumcision and more! Now we don't have to circumcise your child anymore!" How would American parents react? Would they be jumping for joy, or would they request their child be circumcised anyway?

That would be the litmus test for how much we actually give a crap about supposed "medical benefits."

(Here's another surprise; the so-called "benefits" of circumcision ARE already easily achievable through other means; American doctors, parents and "researchers" simply aren't interested.)

Incidentally, for being a nation with a circumcised male majority, the Philippines has one of the worst reputations for HIV transmission. In the 2010 Global AIDS report released by UNAIDS in late November, the Philippines was one of seven nations in the world which reported over 25 percent in new HIV infections between 2001 and 2009, whereas other countries have either stabilized or shown significant declines in the rate of new infections. Among all countries in Asia, only the Philippines and Bangladesh are reporting increases in HIV cases, with others either stable or decreasing.http://globalnation.inquirer.net/news/breakingnews/view/20110102-312124/Philippines-HIVAIDS-problem-worries-UN

Maybe they want to see if they can add that to the Guinness Book of World Records?

American readers may yet delude themselves saying "babies who are circumcised as newborn boys, like we do here in the US, can't remember a thing." But does "not remembering" really make the act any more justifiable?

For readers who stomach it, I encourage you to visit these blogs. Here, parents in Malaysia, Indonesia, and Singapore discuss their baby daughter's "sunat" pretty much the same way American parents talk about their son's circumcisions online. Here too, the subjects of permanent genital modification will also "not remember" what has happened to them. But does this fact justify the act here? What is the list of things that you can do to a child because "s/he can't remember?" And isn't this, the taking advantage of the defenseless, the very definition of abuse?

Bottom line
Abuse is abuse no matter what age, and no matter what sex.

It is sick, disgusting and despicable that the City of Marikina thought it graceful to throw a "circumcision party," and furthermore, to try and put this in the Guinness Book of World Records. We would be disgusted at the exact same notion for a similar event, such as a "sunat party" for girls; this "circumcision party" and the fact that city officials actually think it should be a world record is reprehensible.